Aortic Aneurysm Differential Diagnosis Table

Pulsation in the stomach(Abdomen)-Aortic Aneurysm.

Pulsations in the abdomen are not related to a specific clinical condition but can be the cause of different pathological or physiological conditions. Some of these conditions can be dangerous and deadly like Aortic Aneurysm.

Aortic Aneurysm is basically the bulging out of the wall of the Aorta due to certain conditions which weaken the vessel walls like Marfan syndrome. signs and symptoms become prominent when the bulge enlarges or ruptures. Sometimes the pain originates from the chest which can be caused by a thoracic Aneurysm. The pain is usually sharp like a knife and disturbing.

Aortic Aneurysm can be diagnosed by using ultrasound or CT-scan. It’s so important to be aware of this dangerous clinical condition which can easily lead to death.

Aortic Aneurysm Differential Diagnosis Table:

Aortic aneurysm is a dilatation or widening of the aorta, which is the main artery of our body. It is located in any part of its course, which goes from the exit of the heart into the abdomen.
The types of aortic aneurysm are classified by its anatomy as follows: Thoracic aneurysm: Affects the aorta from the exit of the heart to the thorax through the diaphragm. Abdominal aneurysm: Affects the aorta from its entrance to the abdomen (behind renal arteries) to the level of the navel where they divide into iliac arteries. This is the common type of aneurysm. Thoraco-abdominal aneurysm: It begins at the level of the thoracic aorta to the abdominal aorta.
Aneurysms can be classified according to their characteristics in:
According to their etiology: Atherosclerotic, mycotic, and post-traumatic aneurysm. According to their morphology: Fusiform (affects the entire aorta and is the most common) and saccular (only a part of the aorta is dilated). According to their symptoms: Asymptomatic or symptomatic.
Most aneurysms are asymptomatic; they are detected in an imaging test performed for another reason, so it is a random finding. They can generate lumbar pain or scapulae pain. The most clinical sign (abdominal aneurysm) is palpation of the mass at the level of the navel. Other signs are: chronic cough (can present bleeding), hoarseness, abdominal discomfort, vomiting, swelling of the legs, circulatory problems, bleeding with coughing, weight loss, fever.

How to Distinguish Aortic Aneurysm from Other Diseases

Distinguish Myocardial Infarction from Aortic Aneurysm – Diagnosis

• The clinical presentation is based on: dyspnea, sudden chest pain radiating to the back, shoulders (mostly left), neck even teeth and jaw. Other signs may include: sweating, dizziness, palpitations, and vomiting; however, the most clinical sign in aortic aneurysm (abdominal aneurysm) is palpation of the mass at the level of the navel. Other signs are: chronic cough (can present bleeding), hoarseness, abdominal discomfort, vomiting, swelling of the legs, circulatory problems, bleeding with coughing, weight loss, fever.

Distinguish Pneumonia from Aortic Aneurysm – Diagnosis

• As described above, one of the causes of aneurysms may be due to a mycological agent. The most common clinical presentation consists of: intense dyspnea, chest pain, fever, and hemoptysis (rarely). The most clinical sign (abdominal aneurysm) is palpation of the mass at the level of the navel. Other signs are: chronic cough (can present bleeding), hoarseness, abdominal discomfort, vomiting, swelling of the legs, circulatory problems, bleeding with coughing, weight loss, fever.

Distinguish Pulmonary Embolism from Aortic Aneurysm – Diagnosis

• Usually asymptomatic. The most frequent clinical manifestations or symptoms are: dyspnea, chest pain, dizziness, fainting, fever, and hemoptysis. The most clinical sign (abdominal aneurysm) is palpation of the mass at the level of the navel. Other signs are: chronic cough (can present bleeding), hoarseness, abdominal discomfort, vomiting, swelling of the legs, circulatory problems, bleeding with coughing, weight loss, fever.

Distinguish Gastrointestinal Issues from Aortic Aneurysm – Diagnosis

• A good clinical history must be taken, accompanied by diagnostic imaging. Usually, gastrointestinal diseases have very particular symptoms and clinical signs that can guide you to the affected organ. In this case, the symptoms that would help to rule out aneurysms of the abdominal aorta would be: heartburn, constipation, jaundice, blood in stool and urine, weight loss, signs of peritonitis.

Distinguish Renal Colic from Aortic Aneurysm – Diagnosis

• Renal colic is characterized by the appearance of lumbar or costolumbar colic pain that radiates to the groin or genitals like a pinprick. This pain is accompanied by nausea, vomiting, fever, and urinary discomfort (dysuria, polyuria, hematuria). The most clinical sign (abdominal aneurysm) is palpation of the mass at the level of the navel. Other signs are: chronic cough (can present bleeding), hoarseness, abdominal discomfort, vomiting, swelling of the legs, circulatory problems, bleeding with coughing, weight loss, fever.

Distinguish Musculoskeletal Pain from Aortic Aneurysm – Diagnosis

• Since lumbar pain is one of the main symptoms of aneurysms, it can be confused with musculoskeletal pain. Musculoskeletal pain includes: fatigue, headache, abdominal pain, dizziness, arthralgia, and tachycardia.

Distinguish Dissecting Aortic Aneurysm from Aortic Aneurysm – Diagnosis

• Symptoms include: Sudden retrosternal thoracic stabbing or tearing pain radiating to shoulder blades or back. Profuse sweating, weak pulse, orthopnea, pale skin, dizziness, and abdominal pain. The most clinical sign (abdominal aneurysm) is palpation of the mass at the level of the navel. Other signs are: chronic cough (can present bleeding), hoarseness, abdominal discomfort, vomiting, swelling of the legs, circulatory problems, bleeding with coughing, weight loss, fever.

Common Red Flags Aortic Aneurysm

It is difficult to estimate the prevalence of this condition since most cases are asymptomatic, although it generally affects people over 60 years, especially men.
The diagnosis of aortic aneurysm is made through CT Scan to see its location, diameter, and anatomical structures that may be affecting. Other tests that may be used are: ultrasound, MRI, and PET-CT.
Treatment is based on:

• Non-pharmacological treatment: Maintaining a healthy lifestyle and doing light exercise.
• Pharmacological treatment: Medications to reduce blood pressure to reduce the stress it generates on the vascular wall and to reduce cholesterol (beta-blockers, antiplatelets, and statins).

Surgical treatment is divided into 2 major options: Conventional or open surgery: The affected dilated segment is replaced by a prosthesis.
Endovascular surgery: Consists of a prosthesis through a catheter through the femoral artery into the affected area, and the prosthesis is placed below the aneurysm to avoid the risk of it rupturing.
The selection choice depends on the location of the aneurysm and the characteristics of the patient.
Aneurysms grow throughout life, and if left untreated, they can become dangerous. The most acute complication is aortic dissection and is a vital risk.

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